Healthcare Provider Details

I. General information

NPI: 1174061758
Provider Name (Legal Business Name): JOSEPH LEON BERG PSYD, BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 N MIAMI BEACH BLVD SUITE #301
NORTH MIAMI BEACH FL
33162-3712
US

IV. Provider business mailing address

909 NORTH MIAMI BEACH BLVD SUITE #301
NORTH MIAMI BEACH FL
33160
US

V. Phone/Fax

Practice location:
  • Phone: 305-778-5637
  • Fax:
Mailing address:
  • Phone: 305-778-5637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: